New Under‑the‑Skin Isatuximab Offers More Convenience for Patients
- A new subcutaneous, or under‑the‑skin, version of the targeted drug isatuximab is now approved for patients with multiple myeloma, offering a much faster and more convenient way to receive the powerful drug.
- Isatuximab was already approved as an intravenous treatment (given by IV). The subcutaneous version works the same way, but takes only minutes to administer.
- Studies show it causes far fewer infusion‑related reactions, with only mild injection‑site effects for most patients.
- Patients currently on IV isatuximab may be able to switch, and anyone considering this therapy should talk with their doctor about whether the shorter, easier subcutaneous option fits their treatment plan.
Isatuximab (brand name: Sarclisa) is an established targeted therapy that has been an important part of multiple myeloma treatment for several years. Instead of being given intravenously (through a vein), the subcutaneous formulation is delivered as an injection under the skin, significantly reducing the time spent receiving treatment.
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The subcutaneous formulation is approved for the same treatment settings as the IV formulation, which includes:
- With pomalidomide and dexamethasone for adults with multiple myeloma who have received at least one prior line of therapy that included lenalidomide and a proteasome inhibitor
- With carfilzomib and dexamethasone for adults with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy
- With bortezomib, lenalidomide, and dexamethasone, for adults with newly diagnosed multiple myeloma who are not candidates for an autologous stem cell transplant
Streamlining Treatment
The key advantage of the new approval is convenience. The IV formulation requires administration through a vein and can involve longer visits. The subcutaneous formulation is given as an injection under the skin of the abdomen, typically taking approximately 10 minutes using a small wearable device or about 6 minutes by manual injection.
This can meaningfully reduce the time spent in the infusion center.
In clinical studies, the subcutaneous formulation was also associated with far fewer infusion-related reactions compared with IV isatuximab. Injection-site reactions (such as redness, swelling, or mild pain) can occur but are generally mild and short-lived.
Patients who are currently receiving IV isatuximab may be able to switch to the subcutaneous formulation after completing their first treatment cycle.
Potential Side Effects
Like all cancer therapies, isatuximab may cause side effects.
Common side effects related to the combination treatment, not just isatuximab alone, may include:
- Low blood cell count
- Infections
- Fatigue
- Nausea
- Diarrhea
Because isatuximab can affect immune function and blood counts, patients are monitored closely during treatment, and the healthcare team will provide guidance on infection prevention and management of side effects.
Patients who are currently receiving isatuximab or who may be candidates for this therapy should discuss with their doctor whether the subcutaneous formulation is appropriate for their treatment plan.
“Selection of patients depends on multiple factors, including comorbidities, age, previous drug exposure, and allergy. With this approval, an oncologist will have three additional options for the second line. This improves the overall care of the patient,” Dr. Pandit explains.
Understanding Multiple Myeloma
Multiple myeloma is a rare and incurable type of blood cancer. When you have this cancer, white blood cells called plasma cells (the cells that make antibodies to fight infections) in your bone marrow grow out of proportion to healthy cells.
Those abnormal cells leave less room for your body’s healthy blood cells to fight infections. They can also spread to other parts of your body and cause problems with organs like your kidneys.
Most people diagnosed are in their 60s. However, people younger than 60 can also get this type of cancer, and if you have a close relative with multiple myeloma, that can increase your risk.
WATCH: Recognizing multiple myeloma symptoms.
Multiple myeloma can cause symptoms such as weakness, dizziness, bone pain, and confusion, among other symptoms.
Relapse Options
When your multiple myeloma comes back within about a year, your disease is generally classified as “high risk.”
This usually means that there were residual cells, even in very small numbers, that were either resistant to the treatment from the start or acquired resistance over time.
In other words, not every myeloma cell in your body is precisely the same. Some start with a set of mutations that can give them resistance to treatments and make them more likely to relapse, whereas others develop mutations as a result of treatment.
When multiple myeloma relapses or stops responding to treatments, there are still options, and the approval of subcutaneous isatuximab means that list of options is growing.
Questions To Ask Your Doctor
- I’d like to cut down on the time I spend getting treatment; is the subcutaneous form of isatuximab an option for me?
- What side effects should I be on the lookout for?
- How will I be monitored with subcutaneous isatuximab?
- What happens if my myeloma continues to progress?
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